Polyhydramnios associated with congenital bilateral vocal cord paralysis: A case report.

RATIONALE: Polyhydramnios may develop when the fetus cannot swallow amniotic fluid or the amount of fetal urine increases. Occasionally, unpredictable fetal abnormalities can be diagnosed postnatally. Bilateral vocal cord paralysis in the fetus may cause polyhydramnios, which could be related to impaired prenatal swallowing. PATIENT CONCERN: A 36-year-old multipara underwent an emergent cesarean section because of polyhydramnios and active labor at 35 + 5 weeks of gestation and gave birth to a girl. DIAGNOSIS: The neonate cried feebly and exhibited cyanosis as well as very weak response to stimuli. Chest retraction and stridor were observed. Laryngoscopic examination revealed no movement in both the vocal cords, and bilateral vocal cord paralysis was diagnosed. INTERVENTIONS: When the baby was 40 days old, she underwent tracheostomy to alleviate the persistent stridor and oral feeding difficulties. OUTCOMES: She was discharged at the age of 60 days while in the tracheostomy state. LESSONS: Securing the airway of neonates with bilateral vocal cord paralysis, tracheoesophageal fistula, or muscular dystrophy, which can be detected after delivery in pregnant women with idiopathic polyhydramnios, is important. Therefore, pregnant women with idiopathic polyhydramnios must be attended to by experts, such as neonatologists, anesthesiologists, or otolaryngologists, who can secure the airway.

Congenital ovarian anomaly manifesting as extra tissue connection between the two ovaries: A case report.

BACKGROUND: Ovarian anomalies except for uni- or bilateral streak gonads are rare. We present a rare case of an ovarian anomaly in which both ovaries were connected by extra tissue. CASE SUMMARY: A 32-year-old, primipara with a twin pregnancy at 36 weeks of gestation was admitted to the hospital with severe preeclampsia. She underwent emergency cesarean section owing to persistent headache, blurred vision, and general edema. Following a peritoneal incision, a thin rectangular-shaped tissue was seen in front of the uterus. After delivery, the extra tissue was removed; no other anomalies were reported in either the ovaries or uterus. Pathology results of the removed tissue disclosed a well-vascularized loose stromal tissue with few follicles and scattered luteinized cells. In this case, to prevent pelvic adhesion or intestinal obstruction resulting from volvulus, strangulation, and torsion, the extra tissue was removed. CONCLUSION: We report a case of a rare ovarian anomaly where both ovaries were connected by extra tissue. If the extra tissue extends to the abdominal cavity, it should be removed to prevent pelvic adhesion or abdominal complications including intestinal volvulus, strangulation, and torsion.

Corrective surgery using a gridiron incision for abdominal pain caused by a folded ovary in the third trimester of pregnancy.

INTRODUCTION: Sonography and magnetic resonance imaging (MRI) may be helpful to obtain an accurate diagnosis of acute abdominal pain in pregnancy. Adnexal torsion presenting in the first or second trimester can be confirmed and treated through laparoscopic surgery; however laparoscopic surgery in the third trimester can be difficult owing to the large uterus, and a gridiron incision can be useful. CASE REPORT/CASE PRESENTATION: An 18-year-old gravida 1, para 0 (G1P0) woman at 30 + 4 weeks of gestation presented with sudden-onset cyclic pain in the right lower quadrant. Abdominal ultrasonography showed a normal appendix, and MRI showed a normal appendix and normal ovaries. The patient's prominent tender point was marked and compared with the MR images, which confirmed the mark as the position of the right ovary. Laparotomy was performed through a gridiron incision, and a folded right ovary was identified. The ovary was unfolded, and TachoSil® and Surgicel® were used to maintain the unfolded position. The patient's pain resolved, and her postoperative course was uneventful. She delivered a healthy, 2540-g male baby at 35 weeks' gestation. DISCUSSION/CONCLUSIONS: A gridiron incision was useful to treat a folded ovary in the third trimester and to evaluate the adnexa and minimize uterine manipulation.